Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
LEVONORGESTREL 17.5 MCG/24 HR (UP TO 5 YRS) 19.5MG INTRAUTERINE DEVICE
Low
$0
Average
$2.7k
Median
$2.3k
High
$18.2k
Each hospital's average Cigna rate, under the methodology and billing class chosen below.
740 hospitals; the 90th percentile is 4.0× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
Filter by billing methodology
Filter by billing class
1,033 hospital rates
iThe hospitals that file a Cigna rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Brigham and Women's Hospital Boston, MA percent of total billed charges · outpatientfrom % of charges | 2 | $2.2k | $2.2k | $507 | 23% | 4–40 | $1.6k – $3.0k |
| 2 | St. Lukes Hospital of Kansas City City, KS fee schedule · both | 5 | $2.0k | $1.9k | $319 | 17% | 4–40 | $1.2k – $2.0k |
| 3 | UMass Memorial Health - Milford Regional Medical Center, Inc. Milford, MA percent of total billed charges · outpatientfrom % of charges | 2 | $2.1k | $2.1k | — | — | 2–20 | $2.1k – $2.1k |
| 4 | West Virginia University Hospitals, Inc. Morgantown, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $4.9k | $4.9k | — | — | 2–20 | $4.9k – $4.9k |
| 5 | Wheeling Hospital, Inc. Wheeling, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $4.9k | $4.9k | — | — | 2–20 | $4.9k – $4.9k |
| 6 | City Hospital, Inc. Martinsburg, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $4.8k | $4.8k | — | — | 1–10 | $4.8k – $4.8k |
| 7 | Massachusetts General Hospital Boston, MA percent of total billed charges · outpatientfrom % of charges | 1 | $2.0k | $2.0k | — | — | 1–10 | $2.0k – $2.0k |
| 8 | Mayo Clinic Rochester, MN facility · percent of total billed charges · bothfrom % of charges | 4 | $1.6k | $1.6k | $34 | 2% | 1–10 | $1.6k – $1.7k |
| 9 | Missouri Baptist Medical Center Saint Louis, MO fee schedule · both | 3 | $2.3k | $2.2k | $127 | 6% | 1–10 | $2.0k – $2.3k |
| 10 | NYU Langone New York, NY percent of total billed charges · outpatientfrom % of charges | 22 | $4.6k | $4.6k | — | — | 1–10 | $4.6k – $4.6k |
| 11 | SONORA COMMUNITY HOSPITAL Sonora, CA percent of total billed charges · outpatientfrom % of charges | 1 | $5.3k | $5.3k | — | — | 1–10 | $5.3k – $5.3k |
| 12 | Sturdy Memorial Hospital Attleboro, MA percent of total billed charges · outpatientfrom % of charges | 1 | $1.6k | $1.6k | — | — | 1–10 | $1.6k – $1.6k |
| 13 | University of Wisconsin Hospital and Clinics Authority WI 53718; 1675 Highland Ave Madison, WI percent of total billed chargesfrom % of charges | 1 | $3.2k | $3.2k | — | — | 1–10 | $3.2k – $3.2k |
| 14 | ADVENTIST HEALTH CLEARLAKE HOSPITAL INC Clearlake, CA percent of total billed charges · outpatientfrom % of charges | 1 | $2.2k | $2.2k | — | — | — | $2.2k – $2.2k |
| 15 | ADVENTIST HEALTH MEDICAL CENTER TEHACHAPI Tehachapi, CA fee schedule · outpatient | 1 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 16 | ADVENTIST HEALTH MENDOCINO COAST Bragg, CA percent of total billed charges · outpatientfrom % of charges | 1 | $1.6k | $1.6k | $296 | 18% | — | $1.3k – $1.9k |
| 17 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $2.3k | $2.3k | — | — | — | $2.3k – $2.3k |
| 18 | ALBANY GENERAL HOSPITAL Albany, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $675 | $675 | — | — | — | $675 – $675 |
| 19 | ALBANY GENERAL HOSPITAL Albany, OR professional · fee schedule · outpatient | 2 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 20 | ALICE_PECK_DAY_MEMORIAL_HOSPITAL LEBANON, NH percent of total billed charges · outpatientfrom % of charges | 3 | $1.5k | $1.6k | $46 | 3% | — | $1.5k – $1.6k |
| 21 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · inpatient | 1 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 22 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · outpatient | 1 | $1.2k | $1.2k | — | — | — | $1.2k – $1.2k |
| 23 | AMH Cath Labs LLC Arlington, TX percent of total billed charges · inpatientfrom % of charges | 1 | $3.7k | $3.7k | — | — | — | $3.7k – $3.7k |
| 24 | AMH Cath Labs LLC Arlington, TX percent of total billed charges · outpatientfrom % of charges | 3 | $2.7k | $2.9k | $626 | 22% | — | $2.2k – $3.7k |
| 25 | ANGEL MEDICAL CENTER Franklin, NC percent of total billed charges · outpatientfrom % of charges | 4 | $3.4k | $4.0k | $965 | 24% | — | $3.4k – $5.7k |
← Payers reporting HCPCS J7296 · Snapshot 20261111T120946Z-9134e7f7